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Wow. Have we rid ourselves of a drug that critics claim threatens to undermine morality and all things good?

Hardly.

Let's be honest for a moment about "medicinal" marijuana.

For most users, it's a drug to get high, rather than ease any real physical pain. And it's incredibly easy to get.

Just head to a participating physician, usually around the corner from a "dispensary," where you can explain the throbbing pain in your back, your head, or your stubbed toe, for that matter. Next thing you know, voila! You'll have the magic card that gives you access to the dispensary where you'll be able to purchase medicinal marijuana in all shapes, strengths and means of ingestion.

To be sure, some people are entitled to medicinal marijuana per the objectives of the Compassionate Use Act, passed by the voters in 1996. Several studies point to medicinal marijuana as very helpful to those suffering from glaucoma, arthritis, some cancers, and other diseases with serious pain. For these folks, medicinal marijuana can bring desperately needed short-term relief that they can't get from other drugs or they can get at much higher prices.

It's the overlap between those who use marijuana as a drug of choice and those who use it for palliative purposes that has governments in a tizzy.

In California, policies change from city to city and, seemingly, day to day. It's led cities like Los Angeles to ban the facilities altogether, with exceptions for hospices and home health agencies. That simply means that the customer will go to an adjacent city for his or her weed.

Other cities not only welcome medicinal dispensaries as legitimate enterprises but tax them as they would any other business.

Why the confusion? The state is in a free fall of sorts about operating conditions of medicinal marijuana dispensaries. Despite voter approval of the 1996 ballot proposition, there has never been a definition of what conditions are medicinally relevant. If beauty is in the eye of the beholder, the need of medicinal marijuana has been defined by the patient.

Add to that the federal government's claim of jurisdiction over any marijuana because of its classification as an illegal drug and the confusion only grows.

There may be some clarity in the near future.

The state Supreme Court has a case on its docket that attempts to define whether a local government has the right to ban medicinal marijuana dispensaries, as has been the case in 178 cities and 20 counties. But what about the dozens of cities that allow dispensaries? And what about those who are truly in pain?

Until there are consistent policies at the state and federal levels, local efforts to manage the medicinal marijuana issue will...go up in smoke. It's enough to cause a huge political headache for all sides, which may help to explain why the medical marijuana card has become so popular.

Larry Gerston teaches political science at San Jose State University and is the political analyst for NBC Bay Area.